Suicide epidemic under VA care

EACH MONTH, 1,000 U.S. military veterans attempt suicide while under the care of the U.S. Department of Veterans Affairs (VA), according to a confidential e-mail written by the department's head of mental health services and revealed last week in a San Francisco courtroom. On average, 18 veterans commit suicide every day in the U.S.--out of which, four are veterans of the wars in Iraq or Afghanistan.

This startling reality was presented during the opening day of a class-action lawsuit trial accusing the Veterans Health Administration of failing to provide adequate mental health treatment to former soldiers.

The lawsuit, brought by the groups Veterans for Common Sense and Veterans United for Truth, doesn't seek monetary compensation, but calls upon federal Judge Samuel Conti to intervene to correct the gross inability of the VA system to address the mental health needs of veterans.

Disturbingly, it appears that VA administrators attempted to hide the truth about the number of suicide attempts among veterans treated in VA medical facilities. In a February 2008 e-mail--which begins with "Shhh!"--Dr. Ira Katz, head of mental health for the VA, pondered whether "this is something we should (carefully) address ourselves in some sort of release, before someone stumbles on it?"

In November 2007, the VA claimed that only 790 such suicide attempts took place during the whole year, and Katz vocally criticized a CBS news report that cited much higher statistics, which have now been shown to be accurate.

Advocates for the lawsuit, which went to trial on April 21, want the government to address the epidemic of veteran suicides, which occur at a rate of three to seven times the general population, according to testimony.

The case seeks prompt care for veterans suffering from post-traumatic stress disorder (PTSD), traumatic brain injury and other mental health problems. Additionally, the groups hope to speed up the appeals process for vets denied VA health care benefits and to improve the legal rights for those in the appeals process.

A government lawyer in the case admitted at the start of the hearings that veterans wait an average of 180 to 185 days before their medical claims are addressed. If this six-month waiting period for treatment wasn't appalling enough, however, the VA usually takes even longer to determine whether it will support a claim for soldiers suffering from PTSD, according to Gordon Espamer, an attorney representing both veterans organizations. If treatment is denied, Espamer added, the government generally takes four years to hear a veteran's appeal, according to VA records.

THESE FACTS don't surprise Joe Wheeler, a U.S. Army surgical assistant who sought care from the VA for PTSD after returning from a tour of duty in Iraq.

Wheeler noted that he was assigned a new psychiatrist every 30 to 60 days. "Every single one wanted to change my medication and treatments," he said. "It was a roller-coaster ride, emotionally and medically...I left the VA system because it wasn't helping me at all. And it's not just me--that's the standard of care, rotating residents and interns to take care of PTSD cases."

But when Wheeler left VA care out of frustration, he also had to give up medications that were helping him deal with severe depression, a risky decision that has driven many fellow veterans to attempt suicide. Ultimately, it took over two years for Wheeler to receive compensation from the VA for his PTSD symptoms.

The trial comes on the heels of a study published by the Rand Corporation estimating that 20 percent of soldiers who have served in Afghanistan or Iraq suffer from PTSD or major depression. Rand's study places the approximate number at 300,000 soldiers, but veterans such as Wheeler say the number is likely higher.

"If you're in an encampment taking mortar rounds on a regular basis, you get jumpy around anything that sounds like metal on metal, like a truck gate slamming," Wheeler said. "But it's not considered PTSD when you're in a war zone--it's considered being a good soldier.

"Effective treatment of PTSD is impossible in a war zone. I guess you could say PTSD means that you continue to act like a 'good soldier' when you get home. You're out doing perimeter checks around your own house."

Wheeler feels that the VA's motivations for downplaying the degree of mental health problems among veterans reflect both the callousness of military leadership and a growing sense of crisis. "[Medical personnel] are under enormous pressure from the military to sign off on soldiers and say they are combat ready again, even when these soldiers are not," he said.

Lawyers for the government were quick to point to the VA's increased hiring of mental health professionals over the past two years and an annual mental health care budget of $3.8 billion. Although they claim that amount is substantial, it is roughly equivalent to the amount of money spent in one week on the wars in Afghanistan and Iraq.

Adrienne Kinne, a 10-year U.S. Army veteran and health science specialist who now works at a VA site, says that the current level of funding for veteran's health care is so inadequate that any recent increases are hardly noticeable. She pointed out that the agency currently has a backlog of over 650,000 disability claims, which it has yet to address, a number verified last week in trial testimony.

"Many veterans who do commit suicide do so waiting for an appointment," Kinne said. "The problem isn't that the VA doesn't want to take care of our veterans, it's that our government simply doesn't want to pay the cost of taking care of these veterans once they get home."

Kinne says she's noticed that recent public pressure on the VA led to the administration prioritizing care for Iraq and Afghanistan veterans. But rather than raising the level of care for all patients, due to limited budgets, other veterans now endure even longer waiting periods.

Thus, veterans of the U.S. war on Vietnam are frequently left behind in an overwhelmed system, according to Kinne. For many, "seeing another endless occupation has reactivated their PTSD symptoms," Kinne said. "Soldiers who fought in Vietnam had to struggle for their VA benefits after that war--and just to prove that PTSD was a real problem. Now they are back at the bottom of the list."

Both Kinne and Wheeler are currently involved in Iraq Veterans Against the War (IVAW) and testified about their experiences at the Winter Soldier hearings in March outside of Washington, D.C. Kinne is the New England regional coordinator for the group, and Wheeler recently started a new California chapter in the North Bay Area, near San Francisco.

One of IVAW's three points of unity explicitly calls for adequate mental health care, and both activists see the effort to reach this goal as closely linked to organizing for an end to the U.S. occupations of Iraq and Afghanistan.

Kinne is quick to point out the empty promises made to potential recruits for today's wars. "The government needs to start funding the VA to the level needed to take care of all of our nations veterans from all war times and peace times," she said. "Otherwise, the government should stop promising this level of care to our soldiers as a means to get them to enlist in the first place."